Categories Uncategorized

Tips for navigating digestive health issues 

Read an article about navigating digestive health issues that was published in the Reading Eagle.

When Jennifer Laurence, a registered dietitian from Chester County, was in her 20s she began having a sensitivity to certain foods, leading to a diagnosis of Irritable Bowel Syndrome. At the time, research on IBS was more limited, which left her feeling alone.

“I didn’t get a lot of help in that area when I talked to a doctor at that time,” she said. “Some of the issues we know about today weren’t as prevalent back then.”

Jennifer Laurence Right Balance Nutrition

Laurence, 51, said the landscape has since changed, with many studies on gut health having been conducted in the last two decades.

“The medical community now knows how important it is and how many ways it contributes to our health,” she said. “Twenty-three years ago, we didn’t have that data, and now we understand a lot more about the microbiome — now there is so much more research on it and the importance of gut health and how you can heal your gut with food.”

When she was first diagnosed in 2000, Laurence decided to turn to nutrition in hopes that route might offer her some answers and relief. With the help of an integrative practitioner to analyze her diet, she began taking steps to make changes.

“She helped explain to me the microbiome and imbalances in the gut and really educated me on that and how food could play into the picture,” Laurence said. “Through working with her, I made the connection that certain foods can make you feel great and certain foods can make you feel really sick.”

In the process, she and the practitioner identified foods that Laurence was sensitive to.

“She helped me heal my gut and from there I became really interested in nutrition and interested in supporting people with digestive issues,” she said. “It was a catalyst to me pursuing nutrition as a profession.”

Cutting out certain foods

In the process of cutting out certain foods, they determined healthy, nutritious, balanced foods to replace them so that Laurence didn’t become deficient.

“Dairy was huge for me, and to this day I’m still pretty sensitive to it,” she said. “I had to adjust and find substitutions for that.”

She turned to fortified rice milk as her dairy alternative.

“I had to figure out how to get calcium in my diet from other foods that aren’t dairy,” Laurence said. “I included a lot of leafy greens in my diet, and things like sesame seeds and beans are high in calcium, so that was my protocol.”

Her specific IBS diagnosis was IBS-D (predominantly diarrhea), so she had to make some changes regarding a beverage she was fond of.

“I was a big coffee drinker and I couldn’t have it because coffee stimulates the bowels,” she said. “I had to switch that out for a caffeine-free herbal tea.”

Taking probiotics was also necessary to balance her microbiome.

“I had to eliminate or swap out the foods that were causing the inflammation and add in foods and probiotics to lower the inflammation,” she said. “I was also prescribed an anti-bacterial supplement to kill some harmful bacteria in my gut.”

Felt significantly better

It wasn’t long before Laurence began noticing changes.

“I started seeing improvements in a couple of weeks and then within one to two months, I felt significantly better,” she said.

Nutrition became a central component of her life. After a period of working in finance and later a focus on motherhood, Laurence decided to transition her professional path to dietetics.

In 2016 Laurence founded Right Balance Integrative Nutrition in Wester Chester. Today, she has many clients who contend with IBS.

“Oftentimes I feel when you are given a diagnosis of IBS it is a fairly general term and people feel they just have to live with it,” she said.

Laurence recommended seeing a doctor first to receive a proper diagnosis before seeking guidance from a dietitian.

“Sometimes all the tests come back normal but you kind of feel, ‘Well, now what? What do I do?’” she said. “This is where a dietitian can really pick up and be helpful, because they can talk to you about dietary intervention.”

Treating IBS is not a one-size-fits-all prescription, so when Laurance does nutritional counseling, each protocol is personalized.

“It is customized to each person, and individualized nutrition is so key,” she said. “I can have five people that come to me with IBS and a recommendation might be different for each one of them.”

After listening to a client’s symptoms, Laurence does a digestive assessment that includes looking at their current diet, doing a dietary intake and having clients keep a food log. Next, she determines an appropriate course of action.

“They may or may not need an elimination diet; they may or may not need supplements,” she said. “I have to do those first steps in order to determine their appropriate nutrition prescription.”

Low FODMAP diet

The Low FODMAP diet is one Laurence often recommends to clients, which she noted is fully backed by research. According to Johns Hopkins University, the low FODMAP diet is a three-step elimination diet that targets certain carbohydrates that are hard to digest. You stop eating high FODMAP foods for the first step. Next, you slowly reintroduce them to see which ones are troublesome. And lastly, once you identify the foods that cause symptoms, you can avoid or limit them while enjoying everything else without worry.

Laurence discussed how the trend in low-carb diets, such as Keto and Paleo, can be detrimental to overall gut health and lead to an unbalanced diet.

“They are so low in fiber and probiotics, which you need to feed those probiotics, and they are low in short-chain fatty acids, all of which help to lower inflammatory response in the body,” she said.

Laurence said the number one carbohydrate people feel they can’t eat is fruit.

“People are afraid to eat it and it is high in antioxidants and a great source of fiber,” she said.

Whole grains such as quinoa, barley and oatmeal are ideal whole grains that Laurence recommends people should gravitate toward.

“People come to me all the time and they have eliminated all this stuff from their diet and are eating a lot of protein, a lot of fat and a few veggies, and that’s not great,” she said, recommending carbohydrates should be added to that list. “They should also be eating fruits, grains, beans and starchy vegetables.”

Laurence offers a message she hopes people will take into consideration when it comes to carbohydrates in their diet, which in turn can be beneficial for gut health.

“They don’t have to fear carbohydrates and be afraid of them,” she said. “These foods can be beneficial and serve a purpose.”

Right Balance Integrative Nutrition

Right Balance Integrative Nutrition is a nutrition counseling practice in West Chester, Chester County. Jennifer Laurence, owner of Right Balance, is a registered dietitian and a licensed nutritionist with a master’s degree in Nutrition Education. For more information, visit www.rightbalancenutrition.com, email [email protected] or call 484-401-7837.

About Low FODMAP Diets

The low FODMAP diet is part of the therapy for those with IBS and SIBO (small intestinal bacterial overgrowth). Research has found that it reduces symptoms in up to 86% of people.

Because the diet can be challenging during the first, most-restrictive phase, it’s important to work with a doctor or dietitian, who can ensure you’re following the diet correctly — which is crucial to success — and maintaining proper nutrition.

Low FODMAP is a three-step elimination diet: First, you stop eating certain foods (high FODMAP foods). Next, you slowly reintroduce them to see which ones are troublesome. Once you identify the foods that cause symptoms, you can avoid or limit them while enjoying everything else worry-free.

Source: www.hopkinsmedicine.org

About Irritable Bowel Syndrome

Symptoms of IBS vary, but typically include one or more of the following: abdominal pain, cramping, constipation or diarrhea, bloating, gassiness. Your doctor may order medical tests to rule out other causes of these symptoms.

Triggers: People with IBS have a sensitive intestinal tract in which stress and diet may play a role.

Stress: The colon contains nerves that connect to the brain. For people with IBS, stress can stimulate spasms in the colon, causing discomfort and pain.

Diet: Some people with IBS find symptoms worsen after eating large meals or high-fat foods. Specific foods may also trigger symptoms and can vary from person to person.

Source: www.eatright.org

See the article published in the Reading Eagle.

Categories Gut Health, Advice, Health, Nutrition

Is SIBO the Cause of Your IBS?

Do you struggle with gas, bloating (that gets worse as the day goes on), distention, pain, or chronic IBS? Have you ever stopped to question the root cause? It could be SIBO.

What is SIBO?

Small intestinal bacterial overgrowth (SIBO) is an overgrowth or accumulation of bacteria in the small intestine (SI). Normally, we want a diverse amount of healthy bacteria in the large intestine (colon) but not in the small intestine. The overgrowth in the SI can cause discomfort and a host of other symptoms. Current research indicates that more than 75% of patients with IBS also have SIBO.

What causes SIBO?

  • Low stomach acid (hypochlorhydria) – Stomach acid kills bacteria
  • Compromised motility (gastroparesis, Parkinson’s, scleroderma)
  • Intestinal permeability (leaky gut)
  • Compromised gallbladder
  • Age
  • Food poisoning
  • Traumatic brain injury (TBI)
  • Chronic use of NSAIDs, Antibiotics, or opioids
  • Hypothyroidism
  • Liver dysfunction
  • Chronic pancreatitis
  • Ehlers-Danlos syndrome
  • Intestinal surgery
  • Fistula
  • Genetics
  • Stress

What are signs and symptoms of SIBO?

  • Bloating
  • Diarrhea, Constipation, or a combination of the two
  • Cramping
  • Nausea
  • Pain
  • Reflux
  • Rosacea/Eczema/Psoriasis
  • Migraines
  • Depression
  • Fatigue
  • Weight loss/gain

How do you test for SIBO?

You can test for SIBO using a breath test. Breath tests can be done at your doctor’s office or at home. A brief fast is required (24-48 hours) in which you eat certain foods such as chicken and white rice. During the test, a lactulose or glucose solution is consumed. Once consumed, you will be asked to breath into a bag in intervals for up to 2 hours.

What are the different types of SIBO?

  • Hydrogen dominant
  • Methane dominant
  • Hydrogen sulfide dominant

During testing, different levels of hydrogen and methane gas in the breath will be measured. If there is a rise in either hydrogen or methane at the 90 minute mark, SIBO is present. For hydrogen, a rise in >- 20ppm is indicative of SIBO. For methane, a rise in >- 10ppm is indicative of SIBO

How is SIBO treated?

  • Antibiotics such as Xifaxan/Rifaximin or neomycin
  • Herbal microbials
  • Dietary intervention
  • 5R Gut Protocol

What is the best diet for SIBO?

There are many different diets that have been studied and implemented to help support a patient with SIBO. These include Low FODMAP, the Specific Carbohydrate Diet (SCD), a Bi-Phasic diet, and an Elemental diet. By far the most well researched diet for SIBO is the low FODMAP diet. It is also the most flexible and least restrictive diet of those mentioned, so this is the diet I recommend starting with. Many individuals with SIBO develop food sensitivities, so it is common that by the time they come to see me, they are already avoiding a number of different foods because they have become intolerant to them. The goal with dietary intervention is to implement a diet that will support the treatment phase (when you are taking antibiotics or microbials) and allow you to have a well balanced diet that provides you with adequate calories and nutrition. With any SIBO diet, your goal is to do this temporarily  (on average 6 weeks) until you start to feel better.

If you want to learn more about SIBO or if you have been diagnosed and are looking for dietary support and counseling, contact me here.

Photo Image by Анастасия Гепп from Pixabay

Categories Nutrition, Advice, Health, How To

Are your dietary supplements helping or hurting you?

When it comes to purchasing and consuming nutritional supplements, quality matters. 

Dietary supplements are not regulated by the FDA. This means that commercial brand supplement companies are not being upheld to quality and safety standards like they should be. As a result, many commercial brand supplements can potentially put you at risk.

These risks include:

  • Supplements that contain harmful additives, fillers, or contaminants. One example would be protein powders that were found to contain lead.
  • Supplements that contain versions of nutrients that are poorly absorbed. There are different forms of different micronutrients. For example, B12 and magnesium. The cheaper forms are less absorbed and in the case of magnesium, can lead to cramping and diarrhea. Another example would be folic acid vs folate. Your body needs to convert folic acid to folate but some individuals are poor converters. In these cases, taking folic acid may actually make them feel worse instead of better.
  • Supplements that don’t contain what they say they do. Some may be lacking the amount of the nutrients that they claim, or possibly may not contain those nutrients at all.
  • Supplements that contain inaccurate labeling and contain potential allergens.

Supplement Safety

When purchasing supplements it’s important to know who to trust and what to look for. Here are my top recommendations:

  • Purchase professional grade supplements only. This will guarantee potency, safety and purity of the product. These companies also guarantee the latest science behind formulation and dosage.
  • Purchase directly through the manufacturer or a qualified healthcare practitioner. You will have a professional who can answer any questions that you have about the efficacy of the product, current research studies, clinical findings, and whether or not the supplement is right for you.
  • Look for companies that opt for third party testing. Third party testing ensures that supplements are clean, safe, and contain exactly what they say they do. Companies have to pay for this testing. Since supplements aren’t regulated and this testing isn’t mandated, many companies don’t opt to do it. Professional grade supplement companies pay for third party testing because they stand behind their products and have the safety of their consumers in mind. These supplements may cost a little more as a result, but it’s worth it to know you are purchasing a high quality product.
  • Pay attention to the expiration dates. I have heard stories of clients purchasing from consumer Internet sites like Amazon, only to receive expired products in the mail. There is also no guarantee that your product was stored properly. Think of a probiotic that must be refrigerated. When you buy from sites like Amazon, you have absolutely no way of knowing if that product was stored under the proper conditions. 
  • Know where your supplements are coming from. Supplements should be sold, shipped and tracked directly from where they are being made. A recent news article highlighted the dangers of counterfeit supplements being sold online and branded as professional supplements.
  • Look for the most bioavailable forms of nutrients. These are the forms of a nutrient that will replete deficiencies because your body will absorb it the most.
  • Avoid any products with unnecessary fillers, flavorings, or sugar alcohols that can actually make you feel worse instead of better. The exact opposite of what a supplement is designed to do.

In my practice, I suggest my clients purchase supplements through Wellevate.me. Wellevate only offers professional grade supplements. Safety and purity is guaranteed, the products are third party tested, and they are available directly from the manufacturer. By using Wellevate, you can purchase supplements that are recommended during your nutritional sessions with confidence, versus trying to find similar products in stores and not really knowing if the product is the same. To setup an account, click here

Photo by Adam Nieścioruk on Unsplash

Categories Advice, Exercise, Health, Nutrition, Sleep, Stress

Self Care: Necessity, not luxury

I have been seeing a trend in my practice lately. Clients come into a program with the best of intentions – to focus on their health, heal their bodies, and put themselves first for a change, only to get sucked back into life’s harsh realities that zap their motivation and plan. They reschedule or cancel visits and put their wellness goals on the backburner. I see it over and over, and I understand because at times in my life I have done the same. My father died in September. The weeks preceding his death were anguishing. I didn’t go to the gym and at times I skipped meals. I didn’t sleep. It’s easy to de-prioritize yourself when you are juggling a hectic work schedule, kids, aging parents, or caring for a friend or loved one. The list goes on an on.

Life will always present us with these challenges. This I know for sure. But self-care can really save us in times like these. Fueling our bodies with nourishing food, moving our bodies with some form of physical activity, deep breathing for stress reduction, and of course getting some much needed rest.

Self-care is a necessity, not a luxury. It’s like the instructions the flight crew gives you on an airplane prior to take off – in the event of an emergency, put YOUR oxygen mask on before helping others with theirs. It is ok to prioritize your needs first. This is not an act of selfishness. This is an act of self-love and self-worth.  It is a demonstration of your love for those around you. Because when you give yourself these gifts, you become the best version of YOU.

So don’t feel bad about scheduling your nutrition visit, or going to the gym, or taking the extra time to cook some healthy meals for yourself, or simply taking a break. You are worth every bit of that time.

As a reminder, I do offer virtual counseling. Simply login from a tablet, smart phone, computer or other Wifi connected device. Virtual visits are an easy and convenient way to continue with your sessions without requiring the time to make a trip to the office. And if you are like most of my clients and getting pulled in multiple directions, time is everything.

To schedule a virtual nutrition session, click here.

Photo by Allie Smith on Unsplash

Categories Uncategorized, Advice, Food, Gut Health, Health, Nutrition, Protein

Confused about collagen?

Collagen supplements are becoming increasingly popular. Are you confused by them? You may be wondering whether or not this is something your body needs, or if these types of supplements even work. This post will help you decide if it’s right for you.

Understanding collagen

Collagen is a protein made up of amino acids. It is one of the most prevalent proteins found throughout the body. It is present in bones, skin, tendons, ligaments, cartilage, your intestinal lining, and other fibrous tissues.  The main role of collagen is to provide structural support to your tissues. There are different forms of collagen, but the primary amino acids that comprise it are glycine, proline, and hydroxyproline.

Role of collagen

As we age, collagen levels decrease. This can lead to issues such as osteoarthritis, joint pain, stiff tendons, wrinkled skin, and GI disturbances. As a result, collagen is being added to beauty products and dietary supplements as a means of providing anti-aging benefits, reducing joint pain, supporting healthy bones and healing leaky gut.

Benefits of collagen

While some studies are mixed, there is strong evidence to support the following benefits of collagen

  • Promotes skin elasticity, hydration, anti-aging and improvement in overall appearance.
  • Can increase bone density and reduce bone loss
  • Helps reduce joint pain and stiffness
  • Can increase the process of wound healing

There is moderate evidence to support these additional benefits*

  • May support growth of hair and nails
  • May increase muscle mass
  • May protect against mucosal damage and support a healthy intestinal barrier
  • May support cardiovascular health

*Further studies are needed

Collagen food sources

So how can you obtain collagen naturally? Collagen is mainly found in animal tissue – primarily in the joints, tendons and bones. Bone broth is another common food source. You can purchase commercially made bone broth, but the best way to reap the benefits is to make it yourself. Here is a recipe you can try.

If eating animal carcass or drinking bone broth is not your thing, you can also try consuming foods that synthesize collagen and support its production. These include poultry, game meat, organ meat, fish, shellfish, cheese, egg whites, seeds, spirulina, and soy.

Collagen supplements

Collagen supplements come in a variety of forms including capsules, gummies, powders. One of the most common and versatile forms of collagen supplements can be found in bovine, chicken, or marine collagen peptides.

Collagen peptides are the result of larger collagen molecules being broken down into short chain amino acids. Peptides are ideal because they break down easily in liquids. You can add them to both cold and hot beverages, such as coffee or a smoothie. You can also include them in baked goods.

There is no recommended dietary allowance (RDA) for collagen, but on average 2.5-1.5g per day have been utilized in studies. As with all supplements, I only recommend professional grade brands. Supplements are not regulated so quality really does matter. For example, with some commercial protein powders, there is concern about potential lead contamination. It’s worth investing a few more dollars to know that what you are consuming is safe. As always, before consuming any supplement I urge you to talk with a qualified healthcare practitioner to determine if you really need it.

For more tips like these or to book a session, contact me here

Sources:

  • The Functional Nutrition Library
  • https://health.clevelandclinic.org/
  • https://www.todaysdietitian.com/newarchives/0319p26.shtml
  • https://www.ncbi.nlm.nih.gov/pubmed/23375414
  • https://www.ncbi.nlm.nih.gov/pubmed/25884286